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General NPI Number Information
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NPI Number | 1659003754
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Entity Type | Individual
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Provider Name | DR. NAIRA TAIBA FATIMA
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Gender | Female
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Dates
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Enumeration Date | 06/28/2022
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Last Update Date | 09/17/2025
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Provider Practice Location Address
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Address Line | 801 ILLINI DR
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City | SILVIS
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State | IL
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Zip | 61282-1804
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Country | US
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Telephone | 309-281-5360
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Fax | 309-281-5369
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Provider Business Mailing Address
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Address Line | 1100 BELK BLVD
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City | OXFORD
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State | MS
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Zip | 38655-5242
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Country | US
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Telephone | 301-793-2048
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036174532
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License Number State | IL
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